Autologous fat grafting has become a fundamental tool in reconstructive and aesthetic surgery due to its biocompatibility, availability, and regenerative potential. Among its different modalities, macrofat and microfat have gained relevance because of their distinct biological properties and clinical applications. Macrofat is primarily used for structural volume restoration in deep planes, whereas microfat, due to its smaller particle size and higher stromal vascular fraction content, is more suitable for superficial applications and improvement of skin quality. We present the case of a 58-year-old female patient with moderate facial aging characterized by volume loss in the midface, deep nasolabial folds, and skin quality deterioration. She underwent autologous fat grafting combining macrofat and microfat techniques. Macrofat was applied in deep planes to restore facial contour and structural support, particularly in the malar region, nasolabial folds, and mandibular line. Microfat was injected in superficial planes in the perioral and infraorbital regions to enhance skin texture and fine wrinkles. Postoperative follow-up at 2, 6, and 12 weeks demonstrated satisfactory integration of the graft, with significant improvement in facial volume, contour, and skin quality, without complications such as fat necrosis, infection, or irregularities. The results remained stable at 3 months, with high patient satisfaction. This case highlights the importance of a combined approach using macrofat and microfat to address both structural and superficial components of facial aging. The appropriate selection of technique, processing method, and injection plane is essential to optimize outcomes and achieve natural, long-lasting results in reconstructive facial surgery.
Pohls et al. (Thu,) studied this question.
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